Trotta Giulia, Spinazzola Edoardo, Degen Hannah, Li Zhikun, Austin-Zimmerman Isabelle, Leung Bok Man, Lang Yifei, Rodriguez Victoria, Aas Monica, Sideli Lucia, Wolff Kim, Freeman Tom P, Murray Robin M, Wong Chloe C Y, Alameda Luis, Di Forti Marta
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, UK.
Psychol Med. 2025 Aug 8;55:e220. doi: 10.1017/S0033291725101190.
Childhood trauma is a well-established risk factor for psychosis, paranoia, and substance use, with cannabis being a modifiable environmental factor that exacerbates these vulnerabilities. This study examines the interplay between childhood trauma, cannabis use, and paranoia using standard tetrahydrocannabinol (THC) units as a comprehensive measure of cannabis exposure.
Data were derived from the Cannabis&Me study, an observational, cross-sectional, online survey of 4,736 participants. Childhood trauma was assessed using a modified Childhood Trauma Screen Questionnaire, while paranoia was measured via the Green Paranoid Thoughts Scale. Cannabis use was quantified using weekly standard THC units. Structural equation modeling (SEM) was employed to evaluate direct and indirect pathways between trauma, cannabis use, and paranoia.
Childhood trauma was strongly associated with paranoia, particularly emotional, and physical abuse ( = 16.10, < 0.001; = 16.40, < 0.001). Cannabis use significantly predicted paranoia ( = 0.009, < 0.001). Interactions emerged between standard THC units and both emotional abuse ( = 0.011, < 0.001) and household discord ( = 0.011, < 0.001). SEM revealed a small but significant indirect effect of trauma on paranoia via cannabis use ( = 0.004, = 0.017).
These findings highlight childhood trauma as a primary driver of paranoia, with cannabis use amplifying its effects. While trauma had a strong direct impact, cannabis played a significant mediating role. Integrating standard THC units into psychiatric research and clinical assessments may enhance risk detection and refine intervention strategies, particularly for childhood trauma-exposed individuals.
童年创伤是导致精神病、偏执狂和物质使用的一个公认风险因素，大麻是一个可改变的环境因素，会加剧这些易感性。本研究使用标准四氢大麻酚（THC）单位作为大麻暴露的综合测量指标，来考察童年创伤、大麻使用和偏执狂之间的相互作用。
数据来自“大麻与我”研究，这是一项对4736名参与者进行的观察性横断面在线调查。童年创伤使用经过修改的童年创伤筛查问卷进行评估，而偏执狂则通过格林偏执思想量表进行测量。大麻使用量通过每周标准THC单位进行量化。采用结构方程模型（SEM）来评估创伤、大麻使用和偏执狂之间的直接和间接路径。
童年创伤与偏执狂密切相关，尤其是情感虐待和身体虐待（β = 16.10，p < 0.001；β = 16.40，p < 0.001）。大麻使用显著预测偏执狂（β = 0.009，p < 0.001）。标准THC单位与情感虐待（β = 0.011，p < 0.001）和家庭不和（β = 0.011，p < 0.001）之间均出现了相互作用。结构方程模型显示，创伤通过大麻使用对偏执狂有一个小但显著的间接效应（β = 0.004，p = 0.017）。
这些发现突出了童年创伤是偏执狂的主要驱动因素，大麻使用会放大其影响。虽然创伤有很强的直接影响，但大麻起到了重要的中介作用。将标准THC单位纳入精神病学研究和临床评估可能会提高风险检测并优化干预策略，特别是对于有童年创伤经历的个体。
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